Rule 19: Your child’s Body Mass Index is nobody’s business but yours

My daughter is desperately excited by her upcoming fifth birthday – not least because apparently she will ‘look like six’. She’s not daft; she knows that the labels on the clothes that I buy her now read ‘Age 6-7’, and that she is taller and heavier than some of her friends.

My daughter is not fat – although according to recent research from Newcastle University, eviscerated by Tim Black on spiked, as a parent I would be the last person to admit that she was. But she isn’t a skinnymalinks either. I’m quite pleased about this because I think she looks healthy and beautiful, and my instincts tell me that denying children pudding and sending them to bed hungry is neither necessary nor desirable in this day and age.

The trouble is, when you are constantly incited by government campaigns, health professionals and media reports to calculate and then worry about your child’s Body Mass Index, you find yourself doubting your instincts – and looking at your child in a very peculiar way. Will she pass the test? you wonder, when the school weigh-in programme comes around. If I put a chocolate biscuit in her lunchbox, will people think it’s my fault that she failed?

And so it was when, towards the end of last school term, I received a letter from the local NHS Community Services regarding the ‘height, weight, vision and hearing’ screening programme for reception-class children. Parents were advised to complete a form, which asked for basic health information about the child and gave the opportunity to consent – or not – to their child ‘receiving the Health Assessment Service offered’, and return it to the school forthwith. The covering letter was explicit in its advice that parents really should consent to this: we were told the Health Assessment was necessary ‘to identify any unmet health needs that may impact on your child’s education’; and that if we did not consent, or failed to return the form, ‘your GP will be notified’.

Now, I am not the most organised of parents when it comes to returning forms; but in this case, I actively dithered. I have no problem with vision and hearing screening offered through the school, not least because I can see how problems with eyesight and hearing really can ‘impact on your child’s education’. But screening for height and weight is a different matter. This is a political initiative, introduced a few years ago as part of the government’s war on obesity.

The introduction, in 2006, of a national ‘weigh-in’ scheme via schools, through which parents could be advised about how far down the scale of morbid obesity their children were sitting and through which the government could collect statistics to beef up their claims of a rampant fatness epidemic, was all about meeting the political objective of tackling a presumed public health problem (1). It had, and has, nothing to do with education – unless you take into account a fat kid’s ability to shine at PE.

This was given tacit recognition in the early days of the weigh-in scheme, when parents were given the ability to opt their child out of this aspect of the Health Assessment. But it was quickly discovered that the ‘target group’ – that is, children with less-than-perfect BMI scores – were being removed from the programme by their parents, defeating its stated objective of helping parents to recognise their child’s chubbiness and take appropriate lifestyle measures to address this; and the rules changed to make all parents comply with the screening.

The upshot, certainly in our neck of the woods, was that the political height and weight screening became lumped together with the medically more important hearing and vision screening, and parents are forced to ‘consent’ to all of this or face the scrutiny of their GP. The only basis on which you can ‘opt out’ is by refusing to allow your child’s height and weight measurements to be included in the government’s data collection statistics. Which is what, after far too much soul-searching, I eventually did. Not having the ability to register a protest about my child being weighed or having her individually graded on a scale of fatness (both of which I cared about) I took the only available opportunity of registering any kind of objection, by refusing to let anonymous, meaningless figures about my child be included in national statistics (about which I really don’t give a monkey’s).

Then a funny thing happened. Three weeks into the new school term, I received a message from my GP’s surgery asking me to get in touch, followed by a phone call from a very nice woman involved in the Health Assessment service. The woman explained to me that they had received my consent form after the screening had already taken place in school, and asked whether I would like them to arrange some separate screening for my daughter. I accepted the offer, although I also explained that if I thought there was a problem I would be happy to talk to my GP. After a brief pause, she admitted that, while my daughter had not been screened for vision and hearing because my consent had not been given, they had gone ahead with the height and weight screening, with the result that I would receive a letter telling me how tall my daughter was and how much she weighed, and that these statistics would have already been passed on for collection in the government’s data.

The woman was very apologetic, and took pains to reassure me that all this data was ‘anonymised’. I explained that I did not actually mind the data being collected, but that it seemed rather strange that my lack of consent could be taken seriously when it came to the medically-important part of the screening service that I did want to access, but ignored when it came to the very bit of the service that I was worried about. I raised my concerns that the height and weight screening was a political measure that had nothing to do with my child’s education, and pointed out that – unlike eyesight and hearing – I was perfectly capable of measuring height and weight myself. The woman agreed with me that the height and weight screening was indeed political, and said that was causing those working in this field a lot of problems with parents becoming upset and confused by the whole thing – the last thing that health professionals want to happen.

So, I asked, am I likely to receive a letter categorising my child as underweight, normal, overweight, obese? The woman explained that no, this year they were not categorising children like this, because last year several parents became understandably very upset on hearing that their child had been awarded a fat grade. Consequently, this year parents would be receiving (as I did) a letter that simply informed us how tall and heavy our child was, along with a general paragraph on the importance of having a healthy weight. But, as she pointed out, this would lead to complaints, too, as parents were utterly confused about ‘what it meant’. In other words, simply being told that your child weighs x kilos begs the question of whether you are then supposed to go and work out their Body Mass Index and its presumed relationship to healthy weights and diets – or whether you just chuck the letter in the bin.

I haven’t chucked the letter in the bin – but only because I want to keep it as proof that I do not require surveillance by my GP. The telephone call from my local surgery, staffed by busy, conscientious people who are brilliant when you are ill, turned out to have been placed because I had not returned the screening form in time, and they just wanted to check ‘whether everything is okay’. As it goes, I am not worried that they might be worried – the GP practice knows my family, and I am confident that they realise that the reason we are not visiting the doctor all the time is because, actually, the kids are pretty healthy. But they, too, are forced to play along with an agenda that forces parents to ‘consent’ to surveillance practices that both parents and health professionals know are based on political objectives rather than health imperatives.

What a waste of everybody’s time, skill and energy this all is. And how bad it is for children, that so many people are scrutinising their bodies for signs of a glitch in the BMI calculation, rather than seeing them as little people with so many more exciting challenges ahead than worrying about what they had for breakfast.

Jennie Bristow runs the website Parents With Attitude and is co-author of Licensed to Hug: How Child Protection Policies Are Poisoning the Relationship Between the Generations and Damaging the Voluntary Sector published by Civitas, 2008. (Buy this book from Amazon(UK).)